title: The epidemiological and economic impact of a quadrivalent human papillomavirus (hpv) vaccine in Estonia.
abstract: BACKGROUND
  This analysis assessed the epidemiological and economic impact of quadrivalent human papillomavirus (HPV4: 6/11/16/18) vaccination in Estonia.
  
  
  METHODS
  A dynamic transmission model was used to assess the epidemiological and economic impact of the routine vaccination of 12-year-old girls with a HPV4 vaccine in preventing cervical cancer, cervical intraepithelial neoplasia (CIN) grades 1, 2 and 3 and genital warts.
  
  
  RESULTS
  The model projected that at year 100, HPV4 vaccination would lead to a reduction of HPV 16/18 related cervical cancer incidence and deaths by over 97% and the incidence of HPV 6/11 related genital warts among Estonian women and men by over 94% and 81%, respectively. The incremental cost-effectiveness ratio of the HPV4 vaccination strategy was € 4,889 per QALY gained over a time horizon of 100 years.
  
  
  CONCLUSIONS
  Routine vaccination of 12-year-old girls with HPV4 vaccine appears to be cost-effective in Estonia, in addition to providing both short term and long term health gains.
authors.affiliation: Department of Public Health, University of Tartu, Tartu 50411, Estonia. anneli.uuskula@ut.ee
authors.forename: Anneli
authors.initials: A
authors.lastname: Uusküla
authors.forename: Andres
authors.initials: A
authors.lastname: Müürsepp
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawai
authors.forename: Mait
authors.initials: M
authors.lastname: Raag
authors.forename: Mikk
authors.initials: M
authors.lastname: Jürisson
authors.forename: Matthew
authors.initials: M
authors.lastname: Pillsbury
mesh_terms: D002648:Child; D003218:Condylomata Acuminata / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D015233:Models, Statistical; D030361:Papillomavirus Infections / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics* / Q000276:immunology; D015203:Reproducibility of Results; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology
chemical_list: D053918:Papillomavirus Vaccines